Ernesto Fabré González

Maternal nutritional factors: Significance for the fetus and the neonate

The nutrition of the gestating woman and of the lactating mother has always been a matter of concern and is frequently the object of pharmacological supplementation. During gestation and lactation, nutritional requirements undergo considerable changes. Studies based on nutritional surveys have shown that the diet of the gestating woman in Spain is deficient mainly in iron, folates, zinc and pyridoxin, with an excessive proportion of lipids. These nutritional habits change during gestation, particularly in the final months. The consumption of milk, particularly of semi-skimmed milk, has increased since 1989. Although pharmacological supplements may not be a valid alternative for all situations, they would be applicable in situations of high nutritional risk when the dietary contribution is insufficient. For the rest of the population, it is only necessary to obtain a supplement from a diet suitably enriched with vitamins and minerals.

Urinothorax: An unusual complication of an oncologic gynecological surgery

Urinothorax was first described in 1968 by Corriere et al [1] as the presence of urine in the pleural cavity due to retroperitoneal leakage of accumulated urine, known as a urinoma. Urine enters into the pleural space via diaphragmatic lymphatic or through an anatomical defect in the diaphragm [2,3]. Although classically it was defined as a transudate, on rare occasions it can present as an exudate [4,5]. Urinothorax often goes undiagnosed, but needs to be considered in patients with a pleural effusion of unknown etiology that is also associated with an obstructive uropathy. This unusual type of pleural effusion is frequently unilateral and ipsilateral to the obstructed urinary tract [6]. Other causes of urinothorax include trauma, surgical injury, malignancy of the urinary tract, renal transplantation, and kidney biopsy [7]. The importance of recognizing this entity lies in the fact that the condition is completely reversible when treatment is specifically directed to the correction of the primary cause and drainage of the urinoma. We report a case of a 56-year-old woman who developed a urinothorax following hysterectomy for endometrial cancer. A 56year-old female, with an unremarkable past medical history, consulted us because of postmenopausal bleeding. On physical examination we confirmed uterine bleeding. Ultrasonography demonstrated an 8 mm endometrium, which was biopsied, revealing endometrial adenocarcinoma. The extension study excluded the existence of a secondary disease. The patient underwent an uneventful abdominal hysterectomy and bilateral